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Pires MV, de Lima CJ, Carvalho HC, Moreira LH, Fernandes AB. Effectiveness of intravesical ozone in interstitial cystitis by the O'Leary-Sant symptom index. Int Urogynecol J 2022:10.1007/s00192-022-05383-3. [PMID: 36242631 PMCID: PMC9569001 DOI: 10.1007/s00192-022-05383-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/22/2022] [Indexed: 11/30/2022]
Abstract
Introduction and hypothesis A prospective clinical, preliminary study was performed in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) who were nonresponders to conventional treatment and received intravesical ozone as a therapeutic alternative. Methods Sixteen patients received six applications of intravesical ozone at a concentration of 41 μg/mL. We evaluated therapeutic efficacy by the percentage reduction of Interstitial Cystitis Symptom and Problem Index scores (ICSI/ICPI—the O'Leary–Sant symptom index), recurrence rate, nonresponse, and side effects in scores collected on admission (pre-treatment), at the end of the therapeutic protocol (post-treatment), and 180 days (follow-up) after the last ozone application. Results The mean age of women was 52.9 years (SD: 15.5), and the duration of symptoms was 5.7 years (SD: 7.1). The median ICSI on admission was 17 (IQR: 14.25–19.5) and at follow-up was 0.5 (IQR: 0–2), with a reduction of 97.5% (CI: 85.7–100). The median ICSI/ICPI on admission was 31.5 (IQR: 29–35.2) and at follow-up was 2.0 (IQR: 0–3.75), with a reduction of 92.3% (CI: 88.8–100). The recurrence rate was only 6.25%, and no patients were nonresponders to the treatment. Conclusions The application of intravesical ozone was effective in the treatment of patients with IC/BPS who were nonresponders to conventional therapy, showing a progressive and safe effect, at least in the short term. Supplementary Information The online version contains supplementary material available at 10.1007/s00192-022-05383-3.
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Affiliation(s)
- Maria Verônica Pires
- Biomedical Engineering Institute, Anhembi Morumbi University (UAM), Rua Casa do Ator, 275, São Paulo, SP, 04546-001, Brazil.
| | - Carlos José de Lima
- Biomedical Engineering Institute, Anhembi Morumbi University (UAM), Rua Casa do Ator, 275, São Paulo, SP, 04546-001, Brazil.,Center for Innovation, Technology, and Education (CITÉ), São José dos Campos Technological Park, Estrada Dr. Altino Bondensan, 500, São José dos Campos, SP, 12247-016, Brazil
| | - Henrique Cunha Carvalho
- Center for Innovation, Technology, and Education (CITÉ), São José dos Campos Technological Park, Estrada Dr. Altino Bondensan, 500, São José dos Campos, SP, 12247-016, Brazil.,The Federal University of Technology - Paraná (UTFPR), Via Marginal Rosalina Maria dos Santos, 1233, Bloco B, Campo Mourão, PR, 87301-899, Brazil
| | - Lívia Helena Moreira
- Biomedical Engineering Institute, Anhembi Morumbi University (UAM), Rua Casa do Ator, 275, São Paulo, SP, 04546-001, Brazil.,Center for Innovation, Technology, and Education (CITÉ), São José dos Campos Technological Park, Estrada Dr. Altino Bondensan, 500, São José dos Campos, SP, 12247-016, Brazil
| | - Adriana Barrinha Fernandes
- Biomedical Engineering Institute, Anhembi Morumbi University (UAM), Rua Casa do Ator, 275, São Paulo, SP, 04546-001, Brazil.,Center for Innovation, Technology, and Education (CITÉ), São José dos Campos Technological Park, Estrada Dr. Altino Bondensan, 500, São José dos Campos, SP, 12247-016, Brazil
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Vendruscolo CDP, Moreira JJ, Seidel SRT, Fülber J, Neuenschwander HM, Bonagura G, Agreste FR, Baccarin RYA. Effects of medical ozone upon healthy equine joints: Clinical and laboratorial aspects. PLoS One 2018; 13:e0197736. [PMID: 29813093 PMCID: PMC5973567 DOI: 10.1371/journal.pone.0197736] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 05/08/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to verify whether transient inflammatory reactions induced by intra-articular medicinal ozone administration affect joint components, by in vivo evaluation of inflammatory (prostaglandin E2, Substance P, Interleukin-6, Interleukine-1, Tumor Necrosis Factor), anti-inflammatory (Interleukin-10) and oxidative (superoxide dismutase activity and oxidative burst) biomarkers and extracellular matrix degradation products (chondroitin sulphate and hyaluronic acid) in synovial fluid. METHODS The effects of medicinal ozone were analyzed at two ozone concentrations (groups A and B, 20 and 40 μg/ml, respectively), using oxygen-injected joints as controls (group C); each group received ten treatments (15 ml gas per treatment). Physical evaluation, evaluation of lameness, ultrasonography, and synovial fluid analysis were performed. RESULTS All joints presented mild and transient effusion throughout the study. Group B exhibited the highest lameness score on day 14 (P<0.05), detected by the lameness measurement system, probably because of the higher ozone concentration. All groups exhibited increased ultrasonography scores on day 14 (P < 0.05). Groups A and B exhibited increased proteins concentrations on day 21 (P<0.05). There was no change in hyaluronic acid concentration or the percentage of high-molecular weight hyaluronic acid throughout the experiment. Chondroitin sulfate concentrations decreased in group B, and did not change in group A and C, indicating that neither treatment provoked extracellular matrix catabolism. Cytokine and eicosanoid concentrations were not significantly changed. CONCLUSIONS The ozonetherapy did not cause significant inflammation process or cartilage degradation, therefore, ozonetherapy is safe at both evaluated doses.
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Affiliation(s)
- Cynthia do Prado Vendruscolo
- Department of Clinical Medicine, School of Veterinary Medicine and Animals Science, University of São Paulo, São Paulo, São Paulo, Brazil
- * E-mail:
| | - Juliana Junqueira Moreira
- Department of Clinical Medicine, School of Veterinary Medicine and Animals Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Sarah Raphaela Torquato Seidel
- Department of Clinical Medicine, School of Veterinary Medicine and Animals Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Joice Fülber
- Department of Clinical Medicine, School of Veterinary Medicine and Animals Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Henrique Macedo Neuenschwander
- Department of Clinical Medicine, School of Veterinary Medicine and Animals Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Giancarlo Bonagura
- Department of Large Animals Clinics, Anhembi Morumbi University, São Paulo, São Paulo, Brazil
| | - Fernanda Rodrigues Agreste
- Department of Clinical Medicine, School of Veterinary Medicine and Animals Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Raquel Yvonne Arantes Baccarin
- Department of Clinical Medicine, School of Veterinary Medicine and Animals Science, University of São Paulo, São Paulo, São Paulo, Brazil
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3
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Smith NL, Wilson AL, Gandhi J, Vatsia S, Khan SA. Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility. Med Gas Res 2017; 7:212-219. [PMID: 29152215 PMCID: PMC5674660 DOI: 10.4103/2045-9912.215752] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The use of ozone (O3) gas as a therapy in alternative medicine has attracted skepticism due to its unstable molecular structure. However, copious volumes of research have provided evidence that O3's dynamic resonance structures facilitate physiological interactions useful in treating a myriad of pathologies. Specifically, O3 therapy induces moderate oxidative stress when interacting with lipids. This interaction increases endogenous production of antioxidants, local perfusion, and oxygen delivery, as well as enhances immune responses. We have conducted a comprehensive review of O3 therapy, investigating its contraindications, routes and concentrations of administration, mechanisms of action, disinfectant properties in various microorganisms, and its medicinal use in different pathologies. We explore the therapeutic value of O3 in pathologies of the cardiovascular system, gastrointestinal tract, genitourinary system, central nervous system, head and neck, musculoskeletal, subcutaneous tissue, and peripheral vascular disease. Despite compelling evidence, further studies are essential to mark it as a viable and quintessential treatment option in medicine.
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Affiliation(s)
| | - Anthony L Wilson
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Jason Gandhi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Medical Student Research Institute, St. George's University School of Medicine, Grenada, West Indies
| | - Sohrab Vatsia
- Department of Cardiothoracic Surgery, Lenox Hill Hospital, New York, NY, USA
| | - Sardar Ali Khan
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Department of Urology, Stony Brook University School of Medicine, Stony Brook, NY, USA
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Lu L, Pan C, Chen L, Hu L, Wang C, Han Y, Yang Y, Cheng Z, Liu WT. AMPK activation by peri-sciatic nerve administration of ozone attenuates CCI-induced neuropathic pain in rats. J Mol Cell Biol 2017; 9:132-143. [PMID: 27744376 DOI: 10.1093/jmcb/mjw043] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 05/26/2016] [Indexed: 12/11/2022] Open
Abstract
Neuropathic pain is a debilitating clinical condition with few efficacious treatments, warranting development of novel therapeutics. Ozone is widely used as an alternative therapy for many different pain conditions, with exact mechanisms still elusive. In this study, we found that a single peri-sciatic nerve injection of ozone decreased mechanical allodynia and thermal hyperalgesia, and normalized the phosphorylation of protein kinase C γ, N-methyl-D-aspartate receptor, and extracellular signal-regulated kinase in a chronic constriction injury (CCI) model in rat sciatic nerve. Meanwhile, ozone significantly suppressed CCI-induced activation of spinal microglia. More importantly, the anti-nociceptive effect of ozone depended on the activation of 5'-adenosine monophosphate (AMP)-activated protein kinase (AMPK), which was proved by the fact that the phosphorylated AMPK level increased during the ozone therapy and AMPK antagonist abolished the effect of ozone in vivo and in vitro. In addition, direct injection of AMPK agonist could replicate the anti-nociceptive effect of ozone in CCI rats. In conclusion, our observations indicate that peri-sciatic nerve injection of ozone activates AMPK to attenuate CCI-induced neuropathic pain.
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Affiliation(s)
- Lijuan Lu
- Department of Pain, Affiliated Drum Tower Hospital of Medical School of Nanjing University, Nanjing 210008, China.,Jiangsu Key Laboratory of Neurodegeneration, Department of Pharmacology, Nanjing Medical University, Nanjing 210029, China
| | - Cailong Pan
- Jiangsu Key Laboratory of Neurodegeneration, Department of Pharmacology, Nanjing Medical University, Nanjing 210029, China
| | - Lu Chen
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, China
| | - Liang Hu
- Jiangsu Key Laboratory of Neurodegeneration, Department of Pharmacology, Nanjing Medical University, Nanjing 210029, China
| | - Chaoyu Wang
- Jiangsu Key Laboratory of Neurodegeneration, Department of Pharmacology, Nanjing Medical University, Nanjing 210029, China
| | - Yuan Han
- Jiangsu Key Laboratory of Neurodegeneration, Department of Pharmacology, Nanjing Medical University, Nanjing 210029, China
| | - Yanjing Yang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Zhixiang Cheng
- Department of Pain Management & Cancer Biotherapy Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wen-Tao Liu
- Jiangsu Key Laboratory of Neurodegeneration, Department of Pharmacology, Nanjing Medical University, Nanjing 210029, China
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Teke K, Ozkan TA, Cebeci OO, Yilmaz H, Keles ME, Ozkan L, Dillioglugil MO, Yildiz DK, Dillioglugil O. Preventive effect of intravesical ozone supplementation on n-methyl-n-nitrosourea-induced non-muscle invasive bladder cancer in male rats. Exp Anim 2017; 66:191-198. [PMID: 28228618 PMCID: PMC5543239 DOI: 10.1538/expanim.16-0093] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Although non-muscle invasive bladder cancer (NMIBC) is widely seen in men, most
laboratory studies of new intravesical therapies to prevent NMIBC have been conducted on
female animals. In addition, ozone (O3) has been shown to be a beneficial agent
as an intravesical application in the treatment of various disorders. In the current
study, we evaluated the immunohistopathological and oxidative-antioxidative effects of
intravesical O3 treatment on
n-methyl-n-nitrosourea (MNU)-induced NMIBC. Male
Wistar-Albino rats (n=51) were divided into four groups: sham (n=6), O3 only
(n=15), MNU only (n=15), and MNU+O3 (n=15). The MNU-only and MNU+O3
groups received MNU, and the O3-only group received saline every other week for
10 weeks. The MNU-only group received 1 ml saline in place of O3 treatment,
whereas the O3-only and MNU+O3 groups were treated with 1 ml 25
µg/ml O3 between the 7th and 12th weeks. Rat bladders were
collected in the 15th week for immunohistopathology and oxidant-antioxidant quantitation.
Oxidant-antioxidant parameters were determined by ELISA. Although all surviving rats in
the MNU-only group had preneoplastic (4/11, 36.4%) or neoplastic changes (7/11, 63.6%), a
completely normal urothelium was observed in 2 rats (2/12, 16.7%) in the
MNU+O3-group (P=0.478). More high-grade lesions were observed
in the MNU-only group (4/11, 36.4%) than in the MNU+O3 group (1/12, 8.3%)
(P=0.120). All oxidant-antioxidant parameters significantly increased
(P<0.05) in the O3-only group compared with the sham
group. However, only antioxidant superoxide dismutase was remarkably higher (178.9%,
P=0.060) in the MNU+O3 group compared with the MNU-only
group. This is the first methodologically and pathologically well-described male rat
orthotopic bladder carcinogenesis model with intravesical MNU and administration of
O3 in NMIBC.
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Affiliation(s)
- Kerem Teke
- Department of Urology, Kocaeli University School of Medicine, Eski İstanbul Yolu 10. Km., 41380, İzmit/Kocaeli, Turkey
| | - Tayyar A Ozkan
- Department of Urology, Derince Training and Research Hospital, İbnisina Mahallesi, SSK Hst., 41900 Derince/Kocaeli, Turkey
| | - Oguz O Cebeci
- Department of Urology, Derince Training and Research Hospital, İbnisina Mahallesi, SSK Hst., 41900 Derince/Kocaeli, Turkey
| | - Hasan Yilmaz
- Department of Urology, Kocaeli University School of Medicine, Eski İstanbul Yolu 10. Km., 41380, İzmit/Kocaeli, Turkey
| | - Muhammed E Keles
- Department of Biochemistry, Kocaeli University School of Medicine, Eski İstanbul Yolu 10. Km., 41380, İzmit/Kocaeli, Turkey
| | - Levend Ozkan
- Department of Urology, Kocaeli University School of Medicine, Eski İstanbul Yolu 10. Km., 41380, İzmit/Kocaeli, Turkey
| | - Meltem O Dillioglugil
- Department of Biochemistry, Kocaeli University School of Medicine, Eski İstanbul Yolu 10. Km., 41380, İzmit/Kocaeli, Turkey
| | - Demir K Yildiz
- Department of Pathology, Kocaeli University School of Medicine, Eski İstanbul Yolu 10. Km., 41380, İzmit/Kocaeli, Turkey
| | - Ozdal Dillioglugil
- Department of Urology, Kocaeli University School of Medicine, Eski İstanbul Yolu 10. Km., 41380, İzmit/Kocaeli, Turkey
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Carvalho MA, Bernardes LS, Hettfleisch K, Pastro LDM, Vieira SE, Saldiva SRDM, Saldiva PHN, Francisco RPV. Associations of maternal personal exposure to air pollution on fetal weight and fetoplacental Doppler: A prospective cohort study. Reprod Toxicol 2016; 62:9-17. [PMID: 27103540 DOI: 10.1016/j.reprotox.2016.04.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 03/20/2016] [Accepted: 04/15/2016] [Indexed: 12/21/2022]
Abstract
We determined the influence of maternal air pollution exposure during each trimester of pregnancy on fetal and birth weight and fetoplacental hemodynamics. In total, 366 women with singleton pregnancies were prospectively followed in the city of São Paulo, Brazil. Nitrogen dioxide (NO2) and ozone (O3) were measured during each trimester using passive personal samplers. We evaluated fetal weight and Doppler velocimetry data from the umbilical, middle cerebral, and uterine arteries in the 3rd trimester, and birth weight. Multivariate analysis was performed, controlling for known determinants of fetal weight. Exposure to higher levels of O3 during the 2nd trimester was associated with higher umbilical artery pulsatility indices (PIs) [p=0.013; beta=0.017: standard error (SE)=0.007]. Exposure to higher levels of O3 during the 3rd trimester was associated with lower umbilical artery PIs (p=0.011; beta=-0.021; SE=0.008). Our results suggest that in the environment of São Paulo, O3 may affects placental vascular resistance.
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Affiliation(s)
- Mariana A Carvalho
- Procriar Study Group, São Paulo University, São Paulo, Brazil; Department of Obstetrics and Gynecology, São Paulo University School of Medicine, Brazil
| | - Lisandra S Bernardes
- Procriar Study Group, São Paulo University, São Paulo, Brazil; Department of Obstetrics and Gynecology, São Paulo University School of Medicine, Brazil.
| | - Karen Hettfleisch
- Procriar Study Group, São Paulo University, São Paulo, Brazil; Department of Obstetrics and Gynecology, São Paulo University School of Medicine, Brazil
| | - Luciana D M Pastro
- Procriar Study Group, São Paulo University, São Paulo, Brazil; Department of Obstetrics and Gynecology, São Paulo University School of Medicine, Brazil
| | - Sandra E Vieira
- Procriar Study Group, São Paulo University, São Paulo, Brazil; Department of Paediatric, São Paulo University School of Medicine, Brazil
| | - Silvia R D M Saldiva
- Procriar Study Group, São Paulo University, São Paulo, Brazil; Health Institute, State Health Secretariat, São Paulo, Brazil
| | - Paulo H N Saldiva
- Procriar Study Group, São Paulo University, São Paulo, Brazil; Institute of Advanced Studies of the University of São Paulo, São Paulo University, School of Medicine, Brazil
| | - Rossana P V Francisco
- Procriar Study Group, São Paulo University, São Paulo, Brazil; Department of Obstetrics and Gynecology, São Paulo University School of Medicine, Brazil
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Bakarev MA, Neimark AI, Lushnikova EL, Pichigina AK, Yakovlev AV. Pathomorphological Analysis and Evaluation of Microcirculation in Polyps of the External Urethral Meatus in Women. Bull Exp Biol Med 2015; 160:103-8. [PMID: 26601835 DOI: 10.1007/s10517-015-3109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Indexed: 10/22/2022]
Abstract
Combinations of various factors of polypogenesis determine the formation of a mixed structural phenotype of urethral polyps consisting of heterogeneous changes of the epithelium (hyperplasia, metaplasia, and erosions), inflammatory cell infiltration of the stroma, and dilatation of the venous plexus vessels. Urogenital infections are associated with the predominance of symptoms of inflammation, high serum levels of IL-1β and TNF-α, more extensive areas of inflammatory infiltration and subepithelial microvascular bed, predominance of hyperemic form of microcirculatory disorders. The combination of hyperplastic reactions of the epithelial layer with neoangiogenesis and myofibroblast proliferation in the subepithelial zone confirms the key role of dysregeneratory hyperplasia in the mechanisms of polypogenesis.
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Affiliation(s)
- M A Bakarev
- Institute of Molecular Pathology and Pathomorphology, Novosibirsk, Russia.
| | - A I Neimark
- Institute of Molecular Pathology and Pathomorphology, Novosibirsk, Russia
| | - E L Lushnikova
- Institute of Molecular Pathology and Pathomorphology, Novosibirsk, Russia
| | - A K Pichigina
- Institute of Molecular Pathology and Pathomorphology, Novosibirsk, Russia
| | - A V Yakovlev
- Institute of Molecular Pathology and Pathomorphology, Novosibirsk, Russia
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